News and Notes
C.A.M.W. Conference, May 28th and 29th, 1924.
The fourth C.A.M.W. Conference on Mental Deficiency will be held on Wednesday and Thursday, May 28th and 29tli, 1924, in the Central Hall, Westminster. The Rt. Hon. J. Wheatley, Minister of Health, will attend the opening session and give an inaugural address.
On May 28th, papers will be read, followed by discussion, on “The Best Methods of dealing, Administratively and Educationally, with the Mentally Defective (feeble-minded) child.’’ On May 29th, discussion will take placc in the morning on “The influence of Heredity and Environment in causing Mental Deficiency,” and in the afternoon on “Mental Tests, their value to the Medical Officer, the Educationalist and the Social Worker.”
Tickets, price 3/6, including advance copies of the papers to be read, may be obtained from the Hon. Secretary, C.A.M.W., 24, Buckingham Palace Road, S.W. 1.
A full report of the Conference will be obtainable at the price of 3/- per copy.
The C.A.M.W. and the British Empire Exhibition. ———————————————-The British Empire Exhibition at Wembley this year will draw visitois from all parts of the Empire; among those visitors will be many educationalists, psychologists and others interested in mental welfare work in the Colonies. The Council of the C.A.M.W. have therefore decided to provide, for four weeks during the Exhibition, a special display of educational apparatus and handwoik suitable for the training and teaching of mental defectives. A room has been booked in the pavilion belonging to the International Council of Women, for four weeks, from September 22nd to October 18th, 1924, and during that time the C.A.M.W., with the co-operation of several of the most important Certified Institutions for mental defectives throughout the country, will hold its special exhibition.
Mental Welfare workers will be on duty throughout the four weeks, to answer enquiries, give advice, distribute and sell literature, and explain to visitois the use of the various kinds of apparatus. One of the lecture halls at the Exhibition has also been booked for one day a week during the time of the C. A. M. W. Exhibition, and meetings will be arranged, and the C.A.M.W. Film shewn.
The Annual Meeting of the Association will be held at Wembley on Monday, October 6th, 1924.
Course for Magistrates, March 18th to 21st, 1924. ————————————————-A Short Course for Magistrates in connection with their duties under the Lunacy and Mental Deficiency Acts was held, under the auspices of the C. A. M. W., from March 18th to 21st, 1924. It was the first Course of the kind to be given in this country and aroused much interest, and although the number of Justices attending was relatively small, it is felt that a beginning has been made in what may prove to be a work of very great importance. In all, twenty-eight Justices entered for the Course?six men, and twenty-two women. The majonty came from various parts of England, but one was from Nigeria and two from South Australia.
The instruction given consisted of eight morning lectures, deliveied at the K?yal Sanitary Institute, supplemented by afternoon visits to various Prisons, Remand Homes, Mental Hospitals and Institutions. For the purpose of visiting, the Justices were divided into small groups, so that the greatest possible benefit could be gained.
Sir Leslie Scott, K.C., M.P., gave the inaugural lecture, on Legal Responsibility and Mental Deficiency” ;* Dr J. G. Porter Phillips, Physician Superintendent, Bethlem Royal Hospital, gave three lectures on Mental Disorders, dealing especially with their medico-legal relationships; Dr A. F. Tredgold dealt with the subject of Mental Deficiency in three lectures, paying special attention to the question of defective delinquents, and Dr F. C. Shrubsall gave one lecture on ‘ ‘Legal Administration under the Mental Deficiency Act.’’
Visits were paid to Brixton and Wandsworth Prisons (by courtesy of H.M. Prison Commissioners): to Bexley and Claybury Mental Hospitals, The Manor, Epsom, South Side Home, Streatham, and Ponton Road Place of Detention (by permission of the London County Council) and to Pield Heath House Special Industrial School, Hillingdon.
From the great appreciation expressed by those Justices who attended, there can be no doubt that the Course proved a means of giving valuable information on the subjects of Lunacy and Mental Deficiency, and that this new departure was thoroughly justified. It is hoped to hold a further Course at a later date. Information as to future Courses may be obtained from the Hon. Secretary, C.A.M.W., 24, Buckingham Palace Road, S.W.I.
Short Courses for Teachers of Mentally Defective Children. ——————————————————–The Short Course announced in our last issue is being held in Liverpool as we go to press, with 48 students in attendance.
The number of applications for the Course so greatly exceeded the accommodation available that the Board of Education have authorised the holding of a second Com””! this year to take place in London from July 5th to July 24th. This Course will be primarily intended for teachers who already hold the Certificate for Part II, or who have had considerable experience of Special School work. Applications for further information should be addressed to Miss Evelyn Fox. The Work of the C.A.M.W. Occupational Organisers.
In March 1923, the C.A.M.W. appointed its first Occupational Organiser, Miss Wingate, and we feel that the following record of her work during the past twelve months shows conclusively that the experiment has fully justified itself.
Miss Wingate’s main work has been the starting of Occupation Centres for low-grade defectives, and she has now opened or re-organised 15 Centres in the following areas:?Barrow-in-Furness, Bury St. Edmund’s, Liverpool (3), London (2), Northampton, Stafford, Warwick, Wiltshire (2), Willesden, Worthing and York. She has also carried out the preliminary visiting for the starting of a Centre in Chester, and as soon as a suitable room can be secured, the Centre will be opened. In addition to starting Centres, Miss Wingate has visited, for periods of a month each, Prudhoe Colony and the Howbeck Schools, Hartlepool, and Caterham Institution, where she has advised and assisted the staff in organising a scheme of training for the low-grade children. She has also paid visits to Kettering and Peterborough Institutions (Section 37), and has advised the Guardians on the training and occupation of the defectives under care therein.
Sir Leslie Scott’s address is being printed and will shortly be obtainable, in pamphlet
form, from the C .A.M .W. office.
Miss Wingate visits the children’s homes, when necessary, with the Supervisors of the Centres, and advises parents on matters of training. At the Centres she gives to the Supervisors what help and instruction may be needed in methods of speech training, sense training, physical exercises, games and rhythmic work, handwork, elementary reading, writing and number, etc. She helps with the preparation of apparatus and equipment, making a considerable amount herself, and showing how gifts of material may be utilised to this end, and puts the Supervisors in touch with educational supply firms from which other apparatus can be obtained. She also gives specimen lessons to the children, and helps in the drawing up of suitable syllabuses of work and time-tables. A full report of her work at each Centre is sent to the Central office at the end of her visit.
In October 1923, the Council felt that many Boards of Guardians who were Managers of Institutions approved under Section 37 of the Mental Deficiency Act would be glad to benefit by the services of a specially qualified worker to visit their institutions and advise their staffs with regard to suitable occupations and recreations for the defectives maintained therein, and a second Occupational Organiser, Miss Price, was appointed for this purpose with the approval of the Board of Control, starting work in November 1923. Since this date she has visited Lincoln, Milnthorpe and Settle, and is booked to visit other institutions in the spring. At each institution she stays one month and during that time organises occupations, games and recreation for the older patients, and special methods of training for low-grades, with most successful results.
Letters of appreciation of the work of the Organisers have been received after each one of their visits, and their appointment seems to have met a real need. The Council are most anxious that their services should be utilised to the fullest extent, and applications for them addressed to the Hon. Secretary of the Association, 24, Buckingham Palace Road, S.W. 1., will be welcomed.
We should like to take the opportunity of recording here that this experimental pioneer work has only been made possible by the generosity of two sympathisers, each of whom gave ?50 to enable a start to be made.
Visiting in Mental Hospitals. —————————-Miss Violet Dale, of the Society of the Crown of Our Lord, has sent us the following account of the pioneer work now being done by the Society in connection with the visiting of Mental Hospitals, and zve have great pleasure in bringing it to the notice of our readers:?
‘ ‘This work first started in America?where it is known as Psychiatric Social Service”?in connection with the War.
In England also it had a connection with the War, for Horton Mental Hospital, Epsom, where it started, was used as a Military Hospital. After it reverted to its original status as one of the Mental Hospitals belonging to the London County Council, the Medical Superintendent, Lieut. -Col. Lord, made an appeal for a voluntary worker who would come and visit the patients from outside, not as an L.C.C. Official but as an authorised Hospital Visitor. Thanks to the C.A.M.W., we heard of this request, and fortunately there happened to be a member of the Society of the Crown of Our Lord available to begin the work.
The Visiting Committee of the Hospital had to be satisfied of the desirability of such an innovation, and this position was reached by May 1923, * In most cases the following fee is charged: Salary for the time of the visit, lodging allowance at ?l per week, and third class railway fare from the last place ot work.
when the scheme was approved for all London County Mental Hospitals. Since then, “Visitors” have been found for three?Claybury, Long Grove and Hanwell ?of the remaining seven Hospitals, and all have begun by visiting for a time at Horton to gain some preliminary insight into the work.
Although organised slightly differently in these other Hospitals the work in all of them has a three-fold aspect:?
Visiting the patients in the Hospital.
Doing commissions for the patients.
(3) Visiting the patients’ homes, or friends, on behalf of the doctors. (1) Visiting the Patients.
As at Horton, there are about 1600 patients (nearly all female), it is of course impossible to visit all, and I devote most of my time to the two Reception Wards as it is often to the newly-admitted patients that one can be of most use. In these ‘ ‘acute wards’’ most types of mental disease are represented and as they are later passed on to the other wards, it is possible to follow up those who care to be visited.
At first all patients spend a week in bed, and in one of the Reception Wards (B. Hospital, which is quite separate from the Main building), the beds are wheeled out every day when possible on to the verandah, or into the garden, so that all the patients, except those who have to be in the side-rooms by themselves, can benefit by the fresh air.
All the patients are not of course ‘ ‘accessible’’ to the visitor. I do not mean physically accessible, for all are that, as the Visitor has the keys of all the Wards and the side-rooms and padded rooms are at Horton open all day, with rare exceptions. But they are not mentally accessible. Some cannot speak, sometimes for months, sometimes for years. Some do not want to speak, as in many cases of Dementia Praecox. Some are quite incoherent and apparently unaware of the visitor’s presence, though subsequently she may find that the visit did make a very definite impression and was by no means so fruitless as it seemed at the time. But besides all these more or less inaccessible patients, there are many more who are perfectly coherent and welcome a chat with someone from the outside world.
(2) Commissions for the Patients. ———————————It is for these last patients that one can often do small jobs, which may help to relieve the diseased mind of some part of its worries and anxieties, even if those worries are imaginary. The effort of writing a letter is sometimes too great for these invalids, and as relations are discouraged from visiting for the first month, the Visitor may be a useful link with the patient’s home. It is, I think, an interesting fact that I have never been given a wrong address by any of the patients.
(8) Visiting for the Doctors. ——————————When a newly-admitted insane patient pours out a long story to the doctor it is not always possible to be sure how much of it is true and how much may be delusion. Many quite strange things may be facts. Moreover the relatives apparently often adopt a very unfriendly and suspicious attitude towards the doctor, and are unduly reticent, when they are formally interviewed, and more can sometimes be elicited by means of a friendly chat at the home. Personally when paying these visits I have always found the relatives perfectly friendly. It is to be hoped that more women of the right sort may come forward for this work, so that all the L.C.C. Mental Hospitals may soon have “Visitors,” though the work, as far as the Council are concerned, must for the present be entirely voluntary.’’
Lectures on Mental Disorders for Social Workers. ———————————————–The Course of Lectures advertised on page 48 marks a step forward in awakening the social worker to the importance of the factor of mental hygiene in her work, and we draw the special attention of our readers to the experiment. The lectures have been arranged under the auspices of the Central Association for Mental Welfare and through the kindness of the Medical Superintendent of Bethlem Royal Hospital, and the following extract from the circular which has been issued about them clearly shows their nature and objects:? “Dr Thomas Beaton, who has kindly consented to give the lectures is the Senior Assistant Physician and lecturer in Mental Disease at Bethlem Royal Hospital.
A great advance in knowledge and methods of dealing with mental disorder has taken place during the last few years, and an interest and desire for enlightenment has been felt by all social workers. The problem of the unstable and unbalanced individual confronts them again and again, and it is becoming increasingly evident that some insight into the earliest stages of mental disorder is essential so that the signs and symptoms may be recognised and the right steps taken to secure expert advice and the early treatment so essential for a speedy return to normality.
These lectures are especially designed for the lay worker: they will not be highly technical, but eminently practical and should be exceedingly useful to those engaged in the following branches of social work:
Out-Patient Mental Clinics in General Hospitals. Visiting in Mental Hospitals or Mental After-Care work. Mental Welfare Association. Police Court work (especially in Juvenile Courts). Settlements, Charity Organisations, Societies, etc.
Children’s Care work. ——————-No charge will be made for the course and it is hoped that all who are interested in the subject will make early application for tickets, which can be obtained either from Miss Evelyn Fox, C.A.M.W., 24, Buckingham Palace Road, S.W.I., or from Miss Townsend, 52, Lambeth Road, S.E.
We hope that the lectures will prove that the need for them is appreciated and will make it possible for more ambitious educational experiments of the kind to be subsequently undertaken. The full syllabus will be found on page 48. Mental Defectives and Venereal Disease.
There was set up in 1922 a Government Committee of Inquiry, under the Chairmanship of the Right Hon. the Lord Trevethin, “to consider and report uP?n the best medical measures for preventing venereal disease in the community having regard to administrative practicability, including cost. The Report has recently been issuedf and in it occurs this pronouncement:? ‘ ‘There are found to be a considerable number of persons suffering from venereal disease among mental defectives, and the present arrangements for their control and treatment are inadequate.”
The statement will doubtless be taken by many readers of the Report as indisputable, and obvious, but the Mental Hospitals Committee of the London Count}’’ Council do not concur in it. Whilst recognising that mentally defective girls, if unprotected, are “prone to moral lapses,” the Committee points out J that their County Medical Officer of Health in giving evidence before the Government Committee in question, ‘ ‘emphasised the fact that there is comparatively little evidence as regards the incidence of primary venereal disease amongst the mentally defective and that the number of defectives notified under the Mental Deficiency Act … who have been found to have the disease is small and confined to cases notified from refuges, hostels, hospitals, or prisons.’’ ‘ (The italics are ours). Thus of 300 girls notified from such sources only 65 (between 21 and 22 per cent.) were known to be infected. Amongst imbecile and idiot girls under the supervision of the Council none are recorded to have contracted the disease.
The Mental Hospitals Committee further contend that the Mental Deficiency Act should afford all the protection that is needed to ensure against the risk of venereal infection in the cases of the defectives with whom it deals.
The Mentality of Sexual Offenders. ———————————In a paper recently published in the ‘ ‘Lancet,’’ * Dr Hamblin Smith, Medical Officer of H.M. Prison, Birmingham, gives the results of his special examination into the mental condition of a series of 1000 cases of indecent exposure and indecent assault. His findings are as follows:?
Indecent Indecent Total. Exposure Assault. Insane …….. 4 4 8 Mentally defective …. 11 15 26 Subnormal intelligence …. 2 2 4 Undeveloped physically & Mentall y.. …… ? 1 1 Senile degeneration …. 4 7 11 Epileptic …….. 2 ? 2 Mental conflict .. .. .. 18 13 31 Negative results …… 9 S 17 Total 50 50 100 The number of cases upon which these figures are based is of course not large, but Dr Hamblin Smith considers that from the fact that in only 17 cases were the mental conditions apparently normal, at least one inference of great practical importance may fairly be drawn, viz., the “pre-eminent necessity for the fullest investigation” of these offenders before conviction. Such intensive investigation is, he contends, the key-note to the whole position. t Repoit of Committee of Inquiry on Venereal Disease. H.M. Stationery Office. Price 3d. j L.C.C. Minutes, 4th March, 1924,p. 352. Obtainable from P. S. King & Sons, Great Smith Street, Westminster, S.W.I. Price 6(1. * 2!>,3.24.
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